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ELEVATION CERTIFICATE <br />OMB No. 1880-0008 <br />Expiration Date: November 30, 2022 <br />IMPORTANT: In these spaces, copy the corresponding Information from Section A. <br />FOR INSURANCE COMPANY USE <br />Building Street Address (including Apt, Unit, Suite, and/or Bldg. No_) or P_O. Route and Box No. <br />Policy Number. <br />390 HERON FARM LANE <br />City State ZIP Code <br />Company NAIC Number <br />ELLENSBURG Washington 98928 <br />SECTION E -BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) <br />FOR ZONE AO AND ZONE A (WITHOUT BFE) <br />For Zones AO and A (without BFE), complete Items E1-E5. If the Certificate Is intended to support a LOMA or LOMR-F request, <br />complete Sections A, B,and C. For Items E1-E4, use natural grade, If available. Check the measurement used. In Puerto Rico only, <br />enter meters. <br />El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below <br />the highest adjacent grade (HAG) and the [owed adjacent grade (LAG). <br />a) Top of bottom floor (including basement, <br />erawispace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. <br />b) Top of bottom floor (including basement, <br />creMspece, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. <br />E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1--2 of Instructions), <br />the next higher floor (elevation C2.b in <br />the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. <br />E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. <br />E4. Top of platform of machinery and/or equipment <br />servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. <br />E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's <br />floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this Information In Section G. <br />SECTION F -- PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION <br />The properly owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-rued or <br />conlmunityAssued SFE) or Zone AO must sign here. The statements in Sections A, B, and E are cofrect to the best of my knowledge. <br />Property Owner or Owner's Authorized Representative's Name <br />Address City State ZIP Code <br />Signature Date Telephone <br />Comments <br />❑ Check here If attachments. <br />FEMA Form 086-0-33 (12/19) Replaces aii previous editions. Form Page 3 of 6 <br />